Tuaka Hiko o te Manawa (MEA)

Te taima panui: 5 meneti

He aha te tuaka hiko o te ngākau (MEA)?

Ko te tuaka hiko o te ngākau, te MEA rānei, he ariā e tautuhi ana i te ahunga kupenga o te whakahekenga o te ventricular o te ngākau. E pā ana tēnei ki te ahunga e horapa ai te mahi hiko o te ngākau i roto i te papa rua-ahu (te papa o mua). Ko tēnei ahunga i te nuinga o te wā... maui-matau ve hiku-upoko Ka aromatawaitia rātou i runga i ēnei tuaka.

Ka horapa ōrite te mahi hiko noa o te ngākau puta noa i te uaua o te ngākau, mai i te pūnga atrioventricular matau (pūnga SA). I ​​tēnei horapa, kei tētahi ahunga motuhake te tuaka hiko o te ngākau. Heoi, te whakanui ake i te ventricle (te whakanui rawa) rānei ngā rerekētanga o te arataki o te ventricular Ka taea e ngā āhuatanga pēnei i te aukati peka paihere, te arotahi ectopic rānei te mea ka peka ke tēnei tuaka mai i tōna ahunga noa.

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He aha ngā tikanga hei whakatau i te MEA (Te Rohe Ōhanga Toharite)?

E toru ngā tikanga matua mō te ine, te whakatau tata rānei i te MEA. E ono noa iho ngā momo inenga paerewa o ia tikanga (I, II, III, aVR, aVL, aVF).

1. Tikanga Whakairoiro (Ko te tikanga tino tika engari he roa te wā e pau ana)

I tēnei tikanga, ngā whakaputanga e rua Ka tatauhia te MEA mā te whakamahi i te Derivation I me te aVF (i te nuinga o te wā).

Ngā Hipanga:

1. Whakatauhia te rerekētanga pai, kino rānei mō ia tātaitanga.

• Inehia te tapeke o ngā wāhanga pai me ngā wāhanga kino o te matatini QRS. (Hei tauira, mēnā ko te ngaru R he +5 mm, ā, ko te ngaru S he -2 mm, ko te rerekētanga kupenga he +3 mm.)

2. Tuhia ēnei rerekētanga ki tētahi kauwhata tuaka.

• Tuhia te rerekētanga i roto i te Whakaputa I ki te rārangi whakapae o te kauwhata tuaka.

• Tuhia te rerekētanga i roto i te aVF ki te rārangi poutū o te kauwhata tuaka.

3. Tuhia ngā rārangi poutū mai i ēnei peka ke, ka kimi i te pūwāhi whakawhiti.

4. Tuhia he rārangi mai i tēnei pūwāhi whakawhiti ki waenganui o te kauwhata.

• Ko te koki i hangaia e tēnei rārangi ka homai te MEA (Mean Area Angle).

Ko tēnei tikanga te mea e tino tika ai ngā hua, engari he roa te wā e pau ana nā te mea he nui ake ngā tataunga me ngā tuhi e hiahiatia ana.

2. Mā te whakamahi i te tātaitanga me te peka QRS kupenga teitei rawa.

I tēnei tikanga, ko te maha rawa o ngā taurangi e whakamahia ana hei whakatau i te MEA ko... Te kaha o te ngaru R He pūtake tōna.

Ngā Hipanga:

1. Tirohia ngā matatini QRS i ngā taura peka e ono.

2. Whakatauhia ko tēhea pūtake e whakaatu ana i te ngaru R teitei rawa.

3. Ko te tuaka o tēnei putanga he rite tonu ki te MEA.

He tere ake tēnei tikanga nā te mea me whakatairite noa i te teitei o ngā matatini QRS. Heoi, tērā pea kāore i te tino tika.

3. Whakamahia te huanga me te isoelectricity teitei rawa.

I tēnei tikanga, hei kimi i te MEA te whakaputa i te wā e ōrite ana ngā peka QRS pai me te kino Ka kitea.

Ngā Hipanga:

1. Tirohia ngā matatini QRS i ngā taura peka e ono.

2. Kimihia ko tēhea pūtake kei a rātou ngā wāhanga QRS pai me ngā wāhanga QRS kino e tata ana ki a rātou anō.

3. Ka whakarara te MEA ki te tuaka e poutū ana ki tēnei tātaitanga.

4. Hei whakatau mēnā he pai, he kino rānei te MEA, tirohia mēnā he pai, he kino rānei te matatini QRS i runga i tēnei tuaka poutū.

Ka whakamahia tēnei tikanga hei tere kite i ngā huringa o te tuaka o te ventricle.

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He aha ngā awhe tohutoro mō ngā pekapeka MEA i roto i ngā ngeru me ngā kurī?

Ko te awhe noa mō te MEA i roto i te tangata ko -30° ki te +90° Heoi, he rerekē ēnei here mō ngā kurī me ngā ngeru.

• MEA i roto i ngā ngeru: Te tikanga 0° ki te +160° E whakaaetia ana i roto i a rātou.

• MEA i roto i ngā kurī: Ka rerekē pea tēnei i runga i te momo me te momo tinana o te kurī, engari i te nuinga o te wā... +40° ki te +100° E whakaaetia whānuitia ana tēnei awhe. Mō ngā kurī momo nui, ka rerekē pea tēnei awhe.

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He aha tātou me tatau ai i te MEA?

Mā te mōhio ki tō MEA (Mean Achilles tendon reflex) ka āwhina i te tautuhi i ngā mate maha o te ngākau. Ka taea e ngā āhuatanga e whai ake nei te whakararu i te atrial axial:

• Te whakanui ake i te ventricularMā te pikinga ake o te papatipu uaua o te ventricle ka neke te tuaka hiko ki te hypertrophy.

• Ngā rerekētanga o te arataki ventricularKa whakarerekētia te rere o te hiko i waenga i ngā ventricles e ngā mate pūnaha hiko pēnei i te aukati peka paihere maui (LBBB) me te aukati peka paihere matau (RBBB), ka puta he nekehanga tuaka.

• Ngā manawataki ectopicKa taea e ngā nekehanga rerekē e puta mai ana i te ventricle, pērā i te tachycardia ventricular, te whakarerekē i te tuaka.

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Ngā Huringa me ngā Take o te MEA

1. Te Peke o te Tuaka Mauī

• Ngā Take Pea:

• Te whakanui ake i te ventricle mauiMā te pikinga ake o te papatipu uaua o te ventricle maui ka nekehia te tuaka hiko ki te maui.

• Te aukati o te uaua maui o muaKa nekehia te tuaka ki maui e te aukati i te ara kawe hiko o ngā nekehanga o te ngākau.

• Ngā autō e ahu mai ana i ngā arotahi ectopicKa taea e ngā hiko e puta mai ana i tētahi arotahi rerekē i waho o ngā ventricles te neke haere i te tuaka ki maui.

2. Te Peke o te Tuaka Matau

• Ngā Take Pea:

• Hypertrophy ventricular matauKa nekehia te tuaka hiko ki te matau e te nui haere o te uaua o te ventricle matau.

• Paraka manga paihere matauKa nekehia te tuaka hiko ki te matau nā te aukati i te tuku hiko i roto i te ventricle matau.

• Te whakaheke totoKa taea e te pikinga o te pēhanga i roto i ngā oko pūkahukahu te whakanui i te ventricle matau, ka nekehia te tuaka hiko ki matau.

• Te tachycardia ventricularKa taea e te nekehanga o te tuaka ki te matau te puta mai i tētahi rerenga hiko rerekē e puta mai ana i ngā ventricles.

3. Tuaka Tika (Tuaka e tata ana ki te 0°)

• Ngā Take Pea:

• Te whakanui ake i te ventricularIna rite te rahi o ngā ventricles e rua, kāore te tuaka hiko e neke tika ki tetahi taha, ā, ka noho tonu pea te tuaka tata ki te 0°.

• Ngā mate arataki ventricularIna puta he rerekētanga o te ara iahiko i ngā ventricle e rua, ka noho tonu pea te tuaka hiko ki te tūranga kūpapa.

Ka taea e ēnei huringa te tohu i ētahi āhuatanga o te ngākau, tae atu ki te pikinga o te papatipu uaua o te ngākau (hypertrophy), ngā mate pūnaha ara iahiko (ngā aukati peka pūhui), me ngā nekehanga rerekē e ahu mai ana i ngā ventricles (ventricular tachycardia). He mea nui te aromatawai tika o te MEA hei tautuhi i ēnei āhuatanga.

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Ētahi atu Tuhinga ka hiahia pea koe

• Mahi Hiko o te Manawa
• Te Whakatau i te Rere o te Manawa me te Riiri
• Te mate o te hiahia (Anorexia) me ona take
• Arrhythmias Cardiac i roto i nga ngeru me nga kuri
• Tetralogy of Fallot (TOF)

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"Ko te haerenga e kore e taea anake ko te mea kāore koe e tīmata."

Tony Robbins

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